A Review of Pneumatic Actuators Used for the Design of Medical Simulators and Medical Tools

International audienc

Towards Sustainable and Smart Cities: Replicable and KPI-Driven Evaluation Framework

Sustainability is pivotal in the urban transformation strategy in order to reach more resource-efficient, resilient and smarter cities. The goal of being a sustainable city should drive the decisions for city interventions, and measuring city progress is a key step for this process. There are many initiatives aiming at defining indicators and assessment procedures, but there is no convergence in the definition of terms and application methodologies, making their real implementation complex. Within mySMARTLife project (GA#731297), a KPI-driven evaluation framework has been defined with the aim of covering the multiple pillars of a smart and sustainable city (i.e., environment, energy, mobility, ICT, citizens, economy, governance) in a holistic way. This methodology also defines the concepts and terms to guide urban planners and/or experts at the time of implementing the framework for any specific city. The evaluation framework has been deployed in the cities of Nantes, Hamburg and Helsinki, and some lessons have been learned, such as the necessity of providing a definition of measurement boundary to avoid biased interpretations. Due to a co-creation strategy, the main issues from the cities have been taken into consideration in order to increase the replicability of the results.The authors would like to thank, first, the EC for funding and supporting mySMARTLife project under GA#731297. Second, the authors would like to thank the rest of consortium of mySMARTLife for the contributions in the definition of the framework.Peer ReviewedObjectius de Desenvolupament Sostenible::9 - Indústria, Innovació i InfraestructuraObjectius de Desenvolupament Sostenible::11 - Ciutats i Comunitats SosteniblesPostprint (published version

Sustainable Cities: A KPI-Driven Sustainable Evaluation Framework for Smart Cities

Cities are currently dealing with the sustainable transition from carbon-based economies to carbon-neutral cities. The H2020 mySMARTLife project seeks to demonstrate innovative technologies through the implementation of about 150 innovative energy solutions in the cites of Nantes, Hamburg and Helsinki. The evaluation framework that was defined and validated in the project enables the assessment of the environmental, energy, economic, social, ICT and governance aspects of replicable and sustainable smart city solutions with a high market potential. The main features and the process for their definition will be described in this paper.The authors would like to thank, first, the EC for funding and supporting mySMARTLife project under GA#731297. Secondly, the authors would like to thank the rest of consortium of mySMARTLife for the contributions in the definition of the framework.Objectius de Desenvolupament Sostenible::11 - Ciutats i Comunitats SosteniblesPostprint (published version

Towards Sustainable and Smart Cities: Replicable and KPI-Driven Evaluation Framework

Sustainability is pivotal in the urban transformation strategy in order to reach more resource-efficient, resilient and smarter cities. The goal of being a sustainable city should drive the decisions for city interventions, and measuring city progress is a key step for this process. There are many initiatives aiming at defining indicators and assessment procedures, but there is no convergence in the definition of terms and application methodologies, making their real implementation complex. Within mySMARTLife project (GA#731297), a KPI-driven evaluation framework has been defined with the aim of covering the multiple pillars of a smart and sustainable city (i.e., environment, energy, mobility, ICT, citizens, economy, governance) in a holistic way. This methodology also defines the concepts and terms to guide urban planners and/or experts at the time of implementing the framework for any specific city. The evaluation framework has been deployed in the cities of Nantes, Hamburg and Helsinki, and some lessons have been learned, such as the necessity of providing a definition of measurement boundary to avoid biased interpretations. Due to a co-creation strategy, the main issues from the cities have been taken into consideration in order to increase the replicability of the results.The work presented in this paper is the result of the EU-funded project mySMARTLife, under the H2020 programme with grant agreement no. 731297

Cadherin-23, myosin VIIa and harmonin, encoded by Usher syndrome type I genes, form a ternary complex and interact with membrane phospholipids

Cadherin-23 is a component of early transient lateral links of the auditory sensory cells' hair bundle, the mechanoreceptive structure to sound. This protein also makes up the upper part of the tip links that control gating of the mechanoelectrical transduction channels. We addressed the issue of the molecular complex that anchors these links to the hair bundle F-actin core. By using surface plasmon resonance assays, we show that the cytoplasmic regions of the two cadherin-23 isoforms that do or do not contain the exon68-encoded peptide directly interact with harmonin, a submembrane PDZ (post-synaptic density, disc large, zonula occludens) domain-containing protein, with unusually high affinity. This interaction involves the harmonin Nter-PDZ1 supramodule, but not the C-terminal PDZ-binding motif of cadherin-23. We establish that cadherin-23 directly binds to the tail of myosin VIIa. Moreover, cadherin-23, harmonin and myosin VIIa can form a ternary complex, which suggests that myosin VIIa applies tension forces on hair bundle links. We also show that the cadherin-23 cytoplasmic region, harmonin and myosin VIIa interact with phospholipids on synthetic liposomes. Harmonin and the cytoplasmic region of cadherin-23, both independently and as a binary complex, can bind specifically to phosphatidylinositol 4,5-bisphosphate (PI(4,5)P2), which may account for the role of this phospholipid in the adaptation of mechanoelectrical transduction in the hair bundle. The distributions of cadherin-23, harmonin, myosin VIIa and PI(4,5)P2 in the growing and mature auditory hair bundles as well as the abnormal locations of harmonin and myosin VIIa in cadherin-23 null mutant mice strongly support the functional relevance of these interactions

Circulating adrenomedullin estimates survival and reversibility of organ failure in sepsis: the prospective observational multinational Adrenomedullin and Outcome in Sepsis and Septic Shock-1 (AdrenOSS-1) study

Background: Adrenomedullin (ADM) regulates vascular tone and endothelial permeability during sepsis. Levels of circulating biologically active ADM (bio-ADM) show an inverse relationship with blood pressure and a direct relationship with vasopressor requirement. In the present prospective observational multinational Adrenomedullin and Outcome in Sepsis and Septic Shock 1 (, AdrenOSS-1) study, we assessed relationships between circulating bio-ADM during the initial intensive care unit (ICU) stay and short-term outcome in order to eventually design a biomarker-guided randomized controlled trial. Methods: AdrenOSS-1 was a prospective observational multinational study. The primary outcome was 28-day mortality. Secondary outcomes included organ failure as defined by Sequential Organ Failure Assessment (SOFA) score, organ support with focus on vasopressor/inotropic use, and need for renal replacement therapy. AdrenOSS-1 included 583 patients admitted to the ICU with sepsis or septic shock. Results: Circulating bio-ADM levels were measured upon admission and at day 2. Median bio-ADM concentration upon admission was 80.5 pg/ml [IQR 41.5-148.1 pg/ml]. Initial SOFA score was 7 [IQR 5-10], and 28-day mortality was 22%. We found marked associations between bio-ADM upon admission and 28-day mortality (unadjusted standardized HR 2.3 [CI 1.9-2.9]; adjusted HR 1.6 [CI 1.1-2.5]) and between bio-ADM levels and SOFA score (p < 0.0001). Need of vasopressor/inotrope, renal replacement therapy, and positive fluid balance were more prevalent in patients with a bio-ADM > 70 pg/ml upon admission than in those with bio-ADM ≤ 70 pg/ml. In patients with bio-ADM > 70 pg/ml upon admission, decrease in bio-ADM below 70 pg/ml at day 2 was associated with recovery of organ function at day 7 and better 28-day outcome (9.5% mortality). By contrast, persistently elevated bio-ADM at day 2 was associated with prolonged organ dysfunction and high 28-day mortality (38.1% mortality, HR 4.9, 95% CI 2.5-9.8). Conclusions: AdrenOSS-1 shows that early levels and rapid changes in bio-ADM estimate short-term outcome in sepsis and septic shock. These data are the backbone of the design of the biomarker-guided AdrenOSS-2 trial. Trial registration: ClinicalTrials.gov, NCT02393781. Registered on March 19, 2015

Fracture de l'extrémité distale de l'humérus chez le sujet âgé (à propos de 59 cas)

TOULOUSE3-BU Santé-Centrale (315552105) / SudocSudocFranceF

Process of optimisation for a 4 DOF tele-echography robot

International audienceThis paper deals with processes of optimisation for the design of a four degree-of-freedom robot dedicated to remote ultrasound tele-echography. This robot is designed to track the medical gestures of a remote expert moving an ultrasound probe. The goal is to optimise the kinematic structure by fixing the geometric parameters; these have a significant role in robot configuration singularities, with respect to current medical gestures and mechanism compactness. After choosing a dedicated kinematic structure, several optimisations are presented. Then an optimal choice of geometrical parameters of a global function in relation with kinematic performance indices and compactness is proposed. This robot is soon to be used in the experimental medical phase of the Prosit project

Pharmacovigilance en Médecine Gériatrique : étude sur 2000 malades

National audienc